Stating At Afta
Personal history and reason for inquiry:
29-year-old male. No known drug allergies or medical background surgical interest, go to emergency at the time of query fever. During anamnesis it concerns picture of flu-like symptoms with fever of up to 39.3 ° of four days of evolution that has been treated with paracetamol with appearance, and improvement from three months ago, of lesions at the level of the palate and genital tract.
Physical examination: patient with good general condition. Blood pressure: 120/60. Heart rate: 80 BPM. 99% baseline O2 saturation. Afebrile in the moment of attention.
Cardiac auscultation: Rhythmic and Regular (80 BPM). No puffs or rods. Not extra tonos.
Respiratory auscultation: Hum vesicular preserved. No pathologic noise.
It presents at the level of buccal mucosa, palate, and penile thrush flat without lymph nodes accompanying.
Complementary tests:
- Chest x-ray: normal cardiothoracic index. Without images of condensation or infiltrators.
- Analytical income: only highlights the existence of PCR 66.2.
Evolution:
This is done during your stay in emergency consultation with internal medicine who, after assessment, performs diagnostic autoinflamatoria reaction type Pemphigoid impression, by prescribing high Cefuroxima VO and realization of local water washes hydrogen peroxide 50%. Follow up in consultation by infectious diseases and dermatology was decided to.
Valued the next day in dermatology consultation, is clinical trial of atypical Erythema Multiform and is derived for realization of cutaneous biopsy as well as tracking infectious diseases.
In infectious diseases consultation process auto immune was discarded and the results of the biopsy confirmed the diagnosis of Steven Johnson Syndrome.
Conclusions: most of the dermatological consultations in the Emergency Department are given high without a diagnosis of certainty being completely symptomatic treatment at discharge. The realization of skin biopsies are that lazily leads to the definitive diagnosis of pathology.
